Broken, repetitive funding process endangers Americans’ health

Broken, repetitive funding process endangers Americans’ health
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Another year, another messy, delayed appropriations process that threatens public health. It feels a little like Congress is waking up over and over again to Sonny and Cher’s “I’ve Got You Babe,” a la the film “Groundhog Day,” but in this scenario, the stakes are much higher than Bill Murray’s philosophical dilemma. Whether or not Congress protects adequate funding for federal health safeguards affects the lives and health of millions of Americans.

Raising the budget caps and making investments in federal programs that ensure fundamental health protections — like clean air, clean water, safe food, and biomedical research — should be no-brainers. Americans rely on agencies like the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) to keep them healthy. But since a final funding bill has been repeatedly postponed, appropriations legislation is one of many urgent issues requiring Congressional action.

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Still, some members of Congress and the administration are fighting to gut these agencies’ funding, or even use policy riders to further complicate the process and curtail agency authority to do their lifesaving work.

As the president and CEO of the American Lung Association, I have seen firsthand how federal health programs save lives. For example, seven years ago, NIH’s National Lung Screening Trial found that lung cancer deaths can be reduced by 20 percent for people at high risk for lung cancer. Now, individuals who are at high risk can be screened and their lung cancer can be found early, when it is most treatable. And by implementing and enforcing the Clean Air Act, EPA has driven reductions in air pollution that saved 160,000 lives in 2010 alone. The Centers for Disease Control and Prevention’s highly successful “Tips from Former Smokers” Campaign has helped 500,000 Americans quit smoking for good and millions more make a quit attempt – an important step on the way to successfully quitting.

Yet the slow and halting slog toward finalizing FY18 funding has been defined by dangerous proposals to underfund or even slash these critical programs.

Had Congress adhered to President's Trump’s FY18 budget proposal, our public health and biomedical infrastructures would have been crushed. It proposed cutting NIH by 21 percent, limiting federal funding for Medicaid for the first time, and slashing CDC’s funding. And it would have gutted funding to EPA by a staggering 31 percent. Many of these cuts would curtail the critical work that states, tribes and communities do to protect health locally from tobacco and unhealthy air.  

Unfortunately, the Congressional appropriations process has yielded proposals that continue this dangerous trend of underfunding critical health programs. The package of bills passed by the House in September included cuts for EPA and essential programs at CDC including the Office on Smoking and Health. It would have completely eliminated the Climate and Health Program, a CDC initiative to help communities identify threats and develop effective strategies to protect public health in the face of extreme weather events, heat waves, wildfires and other impacts of climate change. Hurricanes Harvey, Irma and Maria and the historic wildfires in the West tragically illustrate the necessity of more investment in this area, not less.

What’s more, the House bill contained a staggering number of harmful policy riders — riders to make it harder for the U.S. Food and Drug Administration to protect youth and the nation’s public health from e-cigarettes, cigars and other tobacco products; delay more protective ozone pollution standards adopted by EPA in 2015; block initiatives to reduce methane emissions; and keep the federal government from taking into account the full costs and benefits of rules that impact climate change — just to name a few.

These policy riders have no place in appropriations bills. They have nothing to do with funding levels and everything to do with sneaking in policies that would never be passed by Congress as standalone legislation. As evidenced over the past few years, appropriations bills are difficult enough to pass; the addition of policy riders only further bogs down the process.

The result of the consistent failure of Congress to meet its most fundamental responsibility — to establish funding levels for the federal government — is yet another looming deadline to avoid a government shutdown, and a backlog of important legislative issues to resolve at the same time. Insisting on dangerously low funding for critical health programs, or on policy riders that delay or block them altogether, is bad governance.

Congress must prioritize Americans’ health and raise the caps to support investment in key public health programs at EPA, CDC and NIH. I also call upon all members of Congress to oppose harmful policy riders in appropriations bills, especially those that put Americans’ lungs and lives at risk. This is at the core of Congress’ job, to serve the American public.

Harold P. Wimmer is national president and CEO of the American Lung Association.